Just emailed

January's finalized call schedule. One of my partners is notorious for never checking his email. I honestly don't know why I bother emailing him the schedule. He's on Monday the third. Any bets as to me getting a 7:05 am phone call from him on Monday, pissed that he doesn't know that he's on call?

And yes, I know Mondays are officially his day off. But when you take an 11 day vacation, you got to make up some days. He's still only has 8 calls in the month (we have a 3 person call for now).

Merry Christmas!

Been up for hours now (why do kids insist on waking up at the crack of dawn?).

The Wii was a hit. I evidently suck at everything.

Going to go looking for my prime rib recipe for dinner tonight...

Hope everyone is filled with joy.

Crying wolf

Your water probably hasn't broken again. This is the 5th time THIS WEEK that you've called about that.


And you, that pain you've complained about for the last month? The same one every time? I'm still not going to deliver you prematurely, so give it up. I've talked to you (or to L&D about you) every night for the last 3 weeks. This is getting old. You still have more than a month before we will consider delivering you electively.

It's going to be a long month.

More wierdness

Would you bring a RABBIT to your GYN appointment?



I thought not.

I swear, I'm not creative enough to make up this stuff.

Why

Does my daughter inform me that she signed me up for bringing in cookies for the school's party tomorrow at 7:35 pm tonight?

grrrr...

Last batch is in the oven right now. I'm earning BIG time Mommy points.

Seen on L&D today

A onesie over a Pepsi bottle with the words "Mommy loves me more than Pepsi."

My patient's family made it for her - she LOVES Pepsi but didn't touch the stuff while pregnant.

Milestones

My father would have been 62 today.

Nikki and Gavin, may you have a long and happy marriage. May your troubles be little ones and your little ones be no trouble!

ER's Mom's Law of Ectopics

They are only allowed to become symptomatic after 8 pm so that by the time the patient gets to the ER and the evaluation is complete, it is now the wee hours of the morning.

Quarterly meeting

Let the whining start!

And there are a lot of whiny docs. Sweet Jesus, grow up!

And yes, I realize that I'm whining about having to go to this meeting. ;)

I'm pissed

At a particular patient.

I get paged at 2:24 am this morning (my phone was possessed last night and rang every 90 minutes or so). It was L&D, one of the nicest nurses on the line.

"Doc, one of your patients arrived by squad. She's been here about 20 minutes."

"Why'd she come?"

"She had one episode of diarrhea so she called for an ambulance."

A few choice words left my mouth. Evidently the paramedics were still there because Nice Nurse put me on speakerphone and they were laughing at my assessment (have her take some G--D--d Immodium and go home).

Yes, I work in a clinic. Yes, my patients frequently have challenging social situations. I tell people that my job is like residency but with better pay. I honestly enjoy working with and helping those who need help.

But COME ON! Use some common sense! It frustrates me to no end to see stupidity and waste. One gal I delivered last year used the ambulance so frequently, we called her squad girl.

Tonight's calls

3 calls since 5 pm - all women with nausea, vomiting, diarrhea.

ugh.

What night shift doesn't want to hear:

Me saying "The ultrasound showed oodles of ugliness and she needs a section."

Peds wasn't happy. Anesthesia wasn't happy. OR assist wasn't happy. I wasn't happy either, to tell the truth.

SNOW!

Crap.

I hate winter.

Thanksgiving

Just finished my Unthanksgiving** dinner that I fixed for family and friends. Remembering past ones...

Uncle Bud forgetting sugar in the cranberry sauce. *pucker*

Driving to Chicago in late November and getting lost in Chinatown.

Seeing my cousin Anne home from her freshman year of college...I was about 8 and we played a game involving making animal noises.

Being pissed at my mother MY freshman year of college because I wanted to stay in Boston and hang with friends. Instead I got a round-trip ticket to Michigan.

2004, taking care of my 10 month old baby who had had surgery earlier in the week.

My first one at my future in-laws...they have a large extended family who are all local. I think there were close to 50 people at that dinner!

This past year, having lots of friends over for an Unthanksgiving dinner on the Saturday.

**Unthanksgiving is a gathering of friends and family for a good meal but not on Thanksgiving. I host one every year on the Saturday after the official holiday. This year, I made rolls, turkey, stuffing, gravy, mashed potatoes, sweet potatoes, cherry-cranberry chutney, cheesy green beans, pumpkin and apple pies with whipped cream. Everything but the stuffing was made from scratch.

How NOT to be bugged when flying

Read a text called Advanced Vaginal Surgery. Your seatmate will not speak to you (although he may occasionally glance your way in horror).

Must memorialize

This day...all nice patients. Not one crazy among them. No one wanted refills on schedule 2 narcs. Pregnant bellies were beautiful and I didn't leave any room coughing because of second-hand smoke.

Just go!

HP7 was good.

I swear, even when I KNOW something is going to jump out at me, I jump when it happens.

Hubby & I will go next weekend when we have family here to watch the rugrats.

2

More days until Harry Potter!


SQUEE!!!!!!!!!!!!!

I am SO going on Friday.

:)

Ugh

The call gods were running a special on gastroenteritis this weekend.

Never have I seen so many pregnant people come in for nausea, vomiting, diarrhea.

It felt like Groundhog's Day.

Gave a lot of IV fluid and Zofran.

I think the secretarial staff hates me.

Normally, I'll get 1-2 crazies/day. Today, I had 12 well-known to me crazies! By lunch, I was ready to scream.

And risk management wanted to talk to me about a delivery from last month.

I'd drink tonight, but I'm on call.

Lesson learned

So I went to a conference last week. My hubby and I decided to sneak in a mini family vacation since there were several things in the area that we thought the kidlets would want.

We're at Seaworld. It's still fairly early in the day. My kids want to play the carnival game Ring the Bottle. I figure, what the hell? since neither one can throw worth anything. (we tease the girl about being safest by standing where she is aiming!)

Second ring, the girl successfully rings the damned bottle. And THIS is the prize she chooses:




Great. Just what we wanted - a nearly 6 foot pink whale to carry around the park and then to try and get home.

Moral of the story - never let your kids play the carnie games at any place.

HUH?

Had a patient claim to a family member that we told her it was OK to smoke weed in pregnancy as long as it was home-grown.

WTF?

For Grumpy

So at dinner last night, we were talking about brains (don't know how we got onto that subject). And my son asked "What are brains made of?"

"Neurons."

"Morons?"

DH started cracking up and muttered something about his students...

Movietime

If you have young kids (especially horse-crazy ones), Secretariat is a good one for the kids. Interesting story about the horse, great racing scenes, no inappropriate scenes for the little ones.

Heck, I KNOW that the horse won the Triple Crown and my heart was still beating fast during the racing scenes. Some of the photography was amazing!

Both my 6 year old boy and 10 year old girl loved it. The boy thought it was like race cars, only horses.

2:38 am

No, I am not going to start pitocin on you right now. You see, even though you are miserable and uncomfortable and CAN'T MAKE IT ANOTHER DAY, I have some reservations about starting an induction on someone due in November.

Sorry. Go home and stop bothering the L&D night nurses, who already know you, since this is your 5th visit in the last week for the disease "tired of being pregnant."

It's going to be a long October...

ER's Dad has my patients as students

Fall rocks!

Went to the apple orchard today with kidlets. Did the pick-your-own apples thing.

Apples went from tree to pie in less than 3 hours. Pie went from oven to tummies in less than an hour.

Life is good.

12:58 am

Is NOT the time to present to L&D, with the chief complaint that "I'm not eating well."

Just FYI.

And yes, the moon was full last night. The crazy was out in full force.

Thank you

OR Gods, for you hath answered my most wanted prayer.

18 minute (YES! That is NOT a typo!) vaginal hysterectomy. Small, prolapsed uterus in a thin patient.

I will be sending more offerings to you for being so kind to me.

Arrrrr, Matey

Happy Talk Like a Pirate Day!

Ipod Irony

So as I'm scrubbing into surgery last week, my Ipod is playing "A Woman's World" from the musical The Full Monty.

I laughed. And then started belting along with it.

Dear OR Gods

Can I PLEASE have a vaginal hysterectomy that is easy?

I'm tired of these conditions: big uteruses, long vaginas, flabby vaginal walls, floppy labia, narrow pelvic outlets, or some combination thereof.

I am requesting just one vag hyst where the uterus is small, prolapsed to the introitus (which is nice and wide) in a skinny patient.

Thanks in advance!

Wow. Just Wow.

Here's a story that should make us all cringe.

Wow.

a TWO YEAR OLD smoking pot?

Parenting fail.

Wierdest call ever

So I'm on call, and just got paged. My term patient thinks her water broke, so she had her hubby check her.

"He got 2 fingers in and so I'm probably 7 cm dilated! He also felt the head!"


Oy!

Timing

First day of this vacation I wake up to daughter puking. Unfortunately, she didn't make it to the bathroom tile and hit the carpet. :(

First day of last vacation I come down with bronchitis from hell.

Last family vacation ended with my Mom in the ICU with a DVT/PE.

I'm thinking I shouldn't go on vacation.

Rant

I want to strangle patients who:

1. Call after hours for idiotic stuff. See last post.

2. Want me to fill out the "Stop the mean ol' electric company from shutting off my power" when they don't freakin' work! Get off of your lazy ass and job hunt.

3. Use pregnancy as an excuse "I can't work." Honey, I fucking OPERATED the morning I was admitted to the hospital.

4. Go to the ER for "pain" and get their 4th CT scan of the calendar year. Oh, they have no insurance either. And they hospital hop, so no one place knows that she had been scanned last month FOR THE EXACT SAME THING!!!! Gawd, then I get to see her as an "ER follow-up" visit.

5. Bitch that they are in severe pain and can I write for some Lortab? Because you know, she's allergic to Motrin. She got a script for Celebrex. I'll lay good money that there will be a phone call tomorrow...

ARRRRRRRRRRRRRRRGGGGGGGGGGGGGGGGHHHHHHHHHHHH!!!!!!!!!!!!!!!!!!!!

Reminder

Your period coming 5 days early is NOT a reason to call after hours for "emergency" advice.


I. Don't. Care.

Quoteful week.

Lots of good ones this week. Not all from patients (see #1)

1. I had asked for Trendelenberg position from anesthesia, to help in a laparoscopic case. T-berg involves moving the bed such that the head is lower than the feet. Gyns use it to have gravity move bowel out of the pelvis when we're operating. Most CRNAs might give you 2-3 degrees of T-berg, but this one had her nearly doing a handstand.

"Andy, you give good T-berg!...that sounded wrong!"

2. Young patient, in for a birth control refill. I asked if she wanted STD testing. She declined saying she was finally being smart and using condoms. So far, a normal conversation.
Then:
"Since it's just us girls here, you know how it is. You have urges and you can't help yourself with them, so you need a man."

3. Another patient : "Why do I get yeast infections only when he goes down on me?"

4. Yet another patient, here for the first time this pregnancy (37 wks along): "I went to the ER because I thought I felt the baby move."

How NOT to start your call day

L&D nurse : Doc, I know you're not on call for another ten minutes but...

Me : What do you got?

Nurse : Patient came in labor and ruptured. 7 cm. I gave the kid its first rectal.

Me : I'll be right in. Call anesthesia and the assist.

8/9/10

First, happy anniversary to the awesomest in-laws ever. I am truly lucky to have snuck into your family.

Second, miss you Daddy. 5 years now.

CME today

So I went the CME lecture this morning at the hospital.

The lecturer said "So if there is a hip fracture..."

And immediately the voices in my head went "And I need to fix it!"

I got the giggles in the middle of the lecture.

For Ramona

Had a patient today who was so proud of her plastics surgeon's handiwork, she pulled up her shirt to my nurse while she was getting the vitals.

I'll admit, he did a nice job.

AWESOME!!!

"Weird: The Al Yankovic Story" from Aaron Paul

Alpha and Omega

Strange day. Literally saw new beginnings and endings.

Was lucky enough to nuzzle a 2 hour old baby of a friend (I didn't deliver). He is perfect. I had baby fingers curled around my finger. I was stroking little baby feet. Life is good with a baby around...especially one you can give back to the parents! (I LOVE being an aunt!)

Went to a visitation of a coworker's boyfriend, who died unexpectedly. She's devastated.

Got called in at midnight by the ER...a late second trimester demise. She delivered moments after I walked into the room.

A few hours later, caught a baby, whose older, stillborn brother I had caught last year. This morning, after hearing the squalls of this baby, every family member in the room burst into tears. I give moms a hug after every delivery, and this one took some time to extract myself from...the emotions were running high.

Thanks, Grumpy

We now have a new catch-phrase at my house: There is a fracture. I need to fix it.

Talking amongst docs

So I was in the surgeon's lounge this morning, waiting for my case to start. Several other surgeons were in there as well and we were talking about work.

An orthopod remarked that summer is a busy time for them, with all of the ATV/bike accidents. I remarked to him that testosterone, stupidity, and alcohol are good for his business (not necessarily in that order!).

He replied "And yours too!"

You know, he's right.

Thanks, I think

New patient, upon me entering the room : Oh, you're so much prettier than your picture in the doctor directory!

Another Dictionary is Needed

Patient's family member to nurse : I think she needs some pitocium to get a move on.

SQUEE!!!!!!

Only a few more months!!!

Why can't we

Adults be more like kids?

I took the kids to the park the other day. Initially, they were the only kids on the playground, running around, climbing, sliding. Other kids arrived and joined in the fun...and all of the kids just accepted each other as new friends. Both genders, all ages, different ethnicities.

Proof of the song from South Pacific : You've Got to be Carefully Taught. In this song, Lt. Cable, who has fallen in love with a local girl, is fighting with his upbringing and how he was taught "to hate the people your relatives hate."

Dictionary, STAT!

So I was seeing a patient in the office, and she was term.

Her mother asked me "When are you going to seduce her?"

Me and my big mouth immediately responded "Never!"

The patient said "I think my mom means induce."

OB Tidbit

It is NEVER good when the maternal heart rate is 20 beats per minute higher than the fetal heart rate.

Just FYI.

Win some, lose some

Win : What you thought would be a difficult vaginal hysterectomy takes you 29 minutes start to finish.

Lose : Tom Izzo leaving MSU

Win : Weekday call this week was uneventful.

Lose : Got called in at 3 am for a delivery this morning.

Win : She only needed 3 pushes to get the baby out.

Lose : Vaginal hysterectomy turns into abdominal hysterectomy.

New fridge

I hated my old one and then the icemaker goes and dies!

YAY!!!!!!

Happy dance - I'm getting a new one delivered today.

No more icemaker...leaving me more room in the freezer. No more side-by-side doors, which I HATE!!!!!!!!!

:)

The q-word part 2

Dear Call Gods,
I'm so sorry. Can we please be friends again? I promise never to even THINK the q-word ever again.

On this 3 day weekend, I've slept at the hospital 2 nights. Last night, I was at home but being paged every 45 minutes - hour. I finally gave up on the idea of sleep at 4 am and came downstairs to start attacking the coffeepot.

ugh.

DaVinci

So our hospital is barreling ahead with getting a robot. I don't see it adding value to my case load. I already do single incision hysts - they're called vaginal hysterectomies! ;)


But god was it fun playing with it this afternoon...

Awesome day

The vag hyst goes well. The laboring gal gets to complete between OR cases and delivers so quickly, I'm not even delaying my next case! The remaining cases go well. ABBA and the Beatles and Broadway was playing on the stereo. I get my favorite assist. I am home before 2 pm, despite having a full OR day and doing a delivery.

Life is good. ;)

Double digits

My dear daughter, 10 years ago we were lucky enough to welcome you into our life. You have taught us about patience. About the joy of blowing bubbles. About sleep being optional.

Happy 10th birthday, kiddo.

The Q word

I'm on call. I almost hate to type this, but it's been the q word this weekend.

Thank god for small favors.

Mr. Sun

Please, oh please, come back.

I don't know what we did wrong, but we miss you desperately. The farmers can't work in their fields. I can't work on my garden.

Oh, and we're close to flooding again here. My sump pump can only handle so much. So please, make a re-appearance.

Thanks!

Murphy's vacation

Why can't I have a normal vacation?

Why does one always get sick about 2 days into vacation?

Why is it raining (AGAIN) when I had planned on working on my yard? It has rained EVERY weekend I've been off and has been beautiful and sunny every weekend I'm on call.

At least I'm catching up on my to-shred pile.

School Trip

Last fall, I was crazy enough to VOLUNTEER to chaperon a school trip to Chicago.

Fortunately, I am not the only insane parent. There were 32 adults and 29 kids on the trip. Rule number one of parenting : it's better to outnumber them. ;)

We had a blast. The kids are gifted and our school has special classes for them. This year, the overarching theme was architecture. So while in Chicago, we went on architectural tours - a boat cruise, a walking tour of Oak Park, where Frank Lloyd Wright had his studio, a walking tour of the Loop, with emphasis on the architecture. I learned a lot. I walked a lot - my knee is not happy with me.

We went to the Blue Man Group one night. That was flipping AWESOME!!!!!!!! When we got the itinerary for the trip, I was a little hesitant about seeing them. I didn't think it would be my kind of thing. I loved it! We laughed so hard, danced so hard. We were in the nosebleed seats, so ponchos weren't needed.

And why, is the best thing about a vacation for the kids the damned pool? Just wondering.

Busy night

Had nearly every form of labor last night. Several spontaneous. One being induced. Some ended up augmented. Some with, others without epidurals. Multiple positions for pushing.

It was like running a class in various forms of labor. ;) And best of all, a 100% SVD rate, with only 1 person needing stitches.

Quote of the call, from the mother of the patient, who was laboring completely naturally, no pit, no epidural. "Don't you want to push her when she's on her back?"

Favorite L&D nurse - "Why? She's doing awesome as is." (she was curled up in a fetal position, right side down - second patient this week who wanted that position)

After delivery, new grandma "I didn't know that you could push in positions other than on your back!"

So true, it's funny

Very politically incorrect, but funny. It seems like patients are the same everywhere.

Very thorough radiologist

Got a CT report back.

In it, the radiologist notes "Tampon in place."

Thanks. I REALLY needed to know that.

Dumb idea

Climbing up on a ladder to paint the house while 34 weeks pregnant.


*headshake*

Full moon

Was a day or two ago.

In this week, I've had more SHIT than most people get in a year. My tertiary center is asking me "WTF?" I'm asking the same thing to the Flying Spagetti Monster.

I've raced to hospital in excess of 70 mph more than once this week (don't worry, country roads are flat and straight). Nurses are so worried they are incoherent when they call me. "Linda! Shut up and calm down!" (to be fair, a bp of 270 over 150 scared me too!) More than one true crash section under general. Lab values that are consistent with very bad things happening.

I'm blaming the full moon.

How did you forget?

You FORGOT this was in your uterus???????

I think I have figured out why you and your third hubby couldn't have kids.

Conferences

I like going to conferences. This one was in the city where I did my residency...lots of catching up with various people. I was introduced to one of the BIG NAMES tm in our field...he was impressed when he started quizzing the audience during his presentation and I answered every question correctly. He even went into minute trivia trying to get me! Neener-neener!

Heard some data that made me think. Heard some info that will change how I practice. The best one, though, was from an ID doc who presented an update on laws involving HIV testing in our state. Woo Hoo! Less paperwork is now required!

The nice thing about going to conferences is being able to bounce ideas off of other docs. I have challenging patients, so it's nice to hear other people's thoughts on how to care for them. The hard thing about solo practice is that I've lost this.

Damned knee

I swear, I'm "this close" to asking for it to be amputated.

I went to see Jeff again yesterday. X-Rays again are normal...but he aspirated a fair amount of fluid from it and injected steroids. It's feeling ok...better than last week but I'm getting frustrated. I'm in my late 30s and I walk like I'm 70! We talked...it's likely that I have a strong inflammatory reaction and neither one of us thinks surgery again would be prudent (well, I wouldn't let him back in so fast anyway).

Grumble.

Sometimes wrong, never in doubt

At least that's the saying about us surgical types. We're denigrated as non-thinking monkeys, snap-decision makers who always KNOW what they plan to do.

But that's not the case.

We puzzle. I have many options that are non-surgical for multiple diseases. Patient may have PPP (piss-poor protoplasm) and surgery likely would have a prolonged aftermath. The more medical illnesses, the higher the risk of surgery. Chronic pain folks rarely have a good result from surgery...but I'm not going to feed strong pain meds for that. (let the flaming begin).

And that's just before the operating room. We get into a belly...and find stuff we weren't expecting. A hot appy in a person with chronic pelvic pain (call in general surgery). Omental caking in a person with a normal ultrasound (FUCK!). Adhesions everywhere so that we can't even put in our usual port sites (grumble, grumble). Aberrant anatomy so that we're mumbling under our breath "I'm not sure WHAT this is". It's times like these where we think...and then make a decision.

Easy to hard. That's the mantra of a difficult case...Dissect out what you know. Gain control of the anatomy slowly. Plus this gives you time to think and to plan the next step. It also gives the circulating nurse time to run and grab an instrument that you don't usually use, but want this time.

Almost anyone can do the technical part...the trick to being a good surgeon is
1. Knowing if surgery is a reasonable option and
2. Knowing which technical part to do when it's not a straight forward case.

Stupid other doctors

I don't give a fuck what your religion is. But if you pretend to be an OB-GYN and refuse to give OCPs for ANY cause (including treatment of laparoscopic biopsy proven endometriosis) because "My religion doesn't believe in birth control" then you are an idiot and a danger to patients.

Period.

OTOH, thank-you for adding several patients to MY practice.

21 years

So we've been together now for a long time.

Like you said this morning "Our relationship is of drinking age!"

I still love you. I even still like you. And here's to many more years together.

I am a dipshit

Figured out why my garage door wouldn't open when I repeatedly pressed the button.

I was using the remote for the doc's lot, not my garage.

I am a dumbass.

I now remember

Why gardening is such GOOD exercise...

Hoed the area I'm going to be using for my veggie garden this year. It's about 10 by 10. Also weeded 2 flower beds and mulched one. Still have lots to do...

Looking to plant tomatoes, assorted peppers, carrots, and maybe some broccoli. My herb garden has dill, cilantro, thyme, oregano, chives, mint, and sage as perennials. I'll plant some basil in there as well and maybe some rosemary.

Ummm, homemade salsa fresh from the garden...fresh chives on baked potatoes...fresh dill on salmon

I'm getting hungry just thinking about it!

Guys, don't say this

So a patient shows up onto L&D. By golly, she was in labor so I kept her.

She called her husband, who is a contractor.

His response?

BTW, she did not think highly of it...

"But I got concrete coming!"

Facepalm

If you call me at 1:19 am complaining of nausea and vomiting, and I assume that you will follow my instructions to go to L&D.

Fail on Patient #1.

I assume most patients would show up for her surgery.

Patient #2 also fails.

Patient #1 calls at 3:30 pm, complaining of nausea and vomiting. Shelly, working phones, didn't know that I had talked to her earlier and told her to go to L&D.

"Oh, that's what the doc said this morning when I called, but I didn't feel like going."


***FACEPALM****

A Question

Is there anything better than homemade pizza with a beer?

I didn't think so.

A compliment, I think

When the OR staff, in the middle of a bitch of a laparoscopic case involving a woman with a BMI significantly north of 60 tell me:

We'd rather be here than in the general surgeon's or ortho's room.

This is even with frequent cussing coming from my mouth. My assist was cussing too, and he rarely swears.

Grace

I was waiting for a delivery the other day so I wandered over to the hospital library to read some journals while waiting. I grabbed a recent issue of Medical Economics and read.

For those not in medicine, MedEc is a journal that is a mixture of business articles and essays reassuring us that we have chosen a noble field. Well, one essay was an internist talking about how to handle difficult patients (a subject which is of interest to every field within medicine...except pathology). And she ended it as saying these patients present us with the chance to show some grace.

In my current position, I have plenty of opportunities to show grace. Last weekend, I got multiple phone calls from this one patient. I finally told her Sunday to call first thing today and we'd get her in. She called 3 minutes after the phone lines opened and I saw her this morning.

Not an easy patient. Multiple psych issues on top of multiple medical issues. But she likes me and hasn't done some of the stunts that she has for other docs (hence, the reason why she has been booted out of many docs' practices).

And she's not my only one like that. I haven't figured out why, but the difficult and crazy people like me. Maybe like seeks out like. ;)

11:19 pm on a Saturday night...

I am asleep, like many people.

My phone rings. It's the call center. Patch me through please.

It's a patient's family member. Who wants me to admit the patient to the hospital (and is calling from the ER's lobby) because she doesn't shower.

I'm trying to explain that not showering is not a valid reason for hospital admission. I'm pretty sure I'm not getting through.

Shift work sounds pretty nice right about now...

Embrace your geekhood

Weird Al is coming soon to a venue nearby. I saw ads today on TV.

Told DH. We both knew that we had to take the kids to their first concert. They LOVE Weird Al...which may have something to do with the fact that their parents play his CDs frequently.

Gawd, I am such a geek!

Things can still amaze me...

The shock of bright red hair on a newborn.

The similarity between the appearance of the brain and the ovary.

How tall my daughter is.

How much BLOOD can come out of an arteriole that is less than a millimeter in diameter. ("Where the hell's all of that bleeding coming from?")

How much fun being the first one to cut into an abdomen. Fresh tissue...it is a beautiful thing.

How sweet babies smell.

How can that patient fit into size 2 jeans when she is recently postpartum? (Bitch!)

Vacation

Was a much needed escape from daily life.

Went on a romantic getaway with my hubby...only to explore multiple historical Civil War battle sites. ;) It made him happy, so it made me happy. My knee, OTOH, is screaming at me. I might have over done it. The 356 steps at one of the sites was NOT a good idea. Still not sure how I managed that site...

Went on a mother-son bowling outing tonight with the PTA. Evidently, I suck, since all three 6 year olds at my lane beat me. The boy came home crowing about the fact that he knocked over more pins than me. (it wasn't hard to beat me...I'm REALLY bad) Oh, and bowling isn't a good idea with a bum knee.

Caught up on sleep. Took a nap every single day thus far.

Going on a mommy-daughter date this weekend. More Indian food.

Trying to figure out how to retire in 10 years...I could get used to this life of leisure. ;)

My hands

I was looking at my hands the other day. I'm ambidexterous, but use mainly my right hand, as most things in this world are designed for righties.

They are surgeon's hands. Nails short. Unpolished. Multiple callouses - for the right hand, one on the lateral side of my thumb, medial middle finger, and on the web of skin between the third and fourth fingers (where the instrument hits when I palm them). My right middle finger has thickened skin at the tip, which is the finger I use to push knots down, especially in vaginal surgery (it is, after all, the longest finger!)

My left thumb has a mirror callous to its twin. My left index finger has one on the medial edge - right where pickups rub.

My wedding set is currently on the window sill in our kitchen. Haven't worn it in a week. Can't remember the last time I wore a bracelet or a watch.

My hands are relatively small, I wear a size 6, but they can hold so much within them...

Whine

It's the quarterly whiny doctors meeting tonight. I'm trying to decide if I want to go...

Beauty

She was average looking, a teen with the usual acne. Glasses and the perpetual teen sneer.

She was also wildly noncompliant, so I barely knew her when she came in to the hospital to have her baby. I walked into the room and she broke down into the deep, soul-heaving sobs that racked every inch of her being. She is adopting out. Alone and scared, she has realized that she cannot be a parent at this time.

I don't think I have ever seen a more beautiful woman than at that time.

Small town, part lost count

Yes, it's a small town. Delivered one woman today. I used to (in my old practice) work with her aunt, who texted me a photo of her holding the new baby.

There's just a lot of interconnections within this town and I'm starting to weave myself within them. We went out to eat tonight and I saw 5 patients while out. I've had 3 of my daughter's teachers as patients. My two best friends are my patients.

And that's part of being a small town doc.

Remember the small town paper?

Lead sentence in the local police report (copied and pasted directly from the paper's site):



Police were dispatched to a domestic situation involving a naked city couple arguing over "stupid stuff" inside a South Main Street residence Monday.


*snort*

FYI

Grocery shopping on Super Bowl Sunday is a bad idea.

I didn't know it was SBS...usually I go on Fridays but I was bust on Friday and snowed in yesterday.

stupid, stupid, stupid.

I hate SNOW!!!!!

4 foot drifts in our driveway. I slept at the hospital last night after being called in for a potential transport.

Got home this morning after a delivery (glad I stayed overnight!) to find hubby working to clear the driveway. Between the two of us armed with a snowblower and a shovel it still took over an hour to clear the driveway enough for me to get to the garage. My upper back and arms are hurting from the workout.

The neighbor's yard still has grass visible. Stupid wind gusts.

First rule of surgery

Is to never, ever, ever, ever, ever, ever say that "I'm due for a bad case soon, since I've had only good ones lately."

Just don't.

It's a baaaaaaaaaad idea.

I am such a brat

So we have some new (as in fresh out of school) nurses training on L&D. One of them had my laboring gal yesterday.

My patient had a few decels during placement of the epidural, but nothing worrisome. The newbie came out and showed me the strip on the monitor. She then proceeded to stay there and chart something on paper...the monitor is still showing my patient's strip. All of a sudden I shout "Oh, my god, look at the decel!" and jump up. (the strip looks fine, I'm just messing with her)

Newbie's head jerks up, eyes wide, looking like a deer in headlights. I bust up laughing.

The other nurses are cracking up.

I am a brat. And proud of it.

Probably not the best idea in the world...

To jump out of moving car while pregnant just because you're fighting with your baby daddy.

I'm just saying...

Workin' for the weekend...

This week thus far:

a 4 am delivery that pushed for 3+ hours.
a discovery of an allergy to clindamycin via hives and breathing issues.
25 week twins with a foot in the vagina
A BPP of 2/10...in someone with a BMI over 70.
A crash section in someone with fetal heart tones in the 30s for 6 minutes.
An ER hit: "I think I see head!" Yep, doc you do. And dammit, I'm doc o'the-month.

ugh.

Call misadventures, continued

9:42 am. I am sacked out on the couch "watching" cartoons. My cell goes off. I recognize the number as being the call center.

"Hello"

"I have a call for you but I tried to get her to call back tomorrow. It's not an emergency." Hoo boy. Never a good sign. "She's insisting upon talking to you.

"Fine."

"OK, doctor, you're connected to Pita Patient." Crap. Pita is one of those of whom we say "it's going to be a long pregnancy." I talk to her several nights per week as well as the phone nurse talks to her at least twice weekly. And we still have MONTHS before she delivers. My working diagnosis is category 4 - fucking nuts and intent upon making ME (and my staff) nuts too.

"Your office called on Friday and I want to know why."

W.T.F. I mean, WTF!?!?!?!?!?!?!?!?!?!

A. It's Sunday.
B. I'm at home.
C. I have no clue why she was called.
D. I wasn't even IN the office on Friday - it's my day off.

So I nicely tell her I don't know and that she should call tomorrow. She sounded disappointed.

Tag phone nurse, you're it!

Sleep

Is the big downfall of OB. I just finished a delivery...3+ hours of pushing. Please note the time I'm typing this. I can't fall back asleep right now.

My cycle is going to be off for about 2-3 days because of this. The post-call day is doable even if you've been up all night. It's the following day that it hits you hard.

Here's hoping that I can get naps today and tomorrow.

Funny kid

So I'm seeing a patient for a routine OB check. She's brought her daughter along, like many people do. Her little girl is GORGEOUS - long straight red hair, bright blue eyes, impish look on her face. She's 2 1/2 years old and precocious as all get out.

So I knock on the door before I enter, open the door and almost trip over the kid, who is right by the entrance to the room.

"You scared me!" she said.

"Sorry."

"Curly hair scares me." I have super curly brown hair.

"You should see me when I first wake up." The patient is cracking up at the exchange.

How do you

tell a woman her baby has a lethal anomaly?

And yes, I'm sure. My sonographer is excellent. The pictures are crystal clear, textbook perfect. The sonographer came out of the room in tears and called me.

Got her squeezed in yesterday to see me after her scan. She and her husband are in shock.

This is the 6th one since July for my practice. We've had about 170 deliveries in that time frame. And most of them have been related to one particular organ system.

I think I'm going to be talking to our local health department...it just feels like too many. I'm not sure the HD will do anything, it's relatively impotent (hence the reason my little clinic does the STD testing).

OB is happy until it's not.

More awesomeness

Whiny first time mom, being induced for being overdue and 4 cm dilated (ie elective induction, but one with a good chance of succeeding). She's been very whiny from 32 weeks on.

Now, before people start in on me, most pregnant women start whining right around that time. I don't know a late in pregnancy woman who can sleep comfortably or go more than an hour without peeing or can breathe deeply easily. It's just the way it is, and it sucks. I know, I have two kids so I give sympathy than point out that "yep, you're normal. You're pregnant."

So, back to my point. Patient gets to complete. 24 minutes of pushing. 10 pounds, 5 ounces. No shoulder issues. No tears.

Day-um!

No wonder she was whiny!

Awesomeness, redefined

So hubby just got home from work. He said he heard this ad on the local sports radio station. Evidently, some urologists have started running an ad urging men to get vasectomies in March. They were emphasizing the need to stay home and rest and watch TV during the recovery period.

The tag line?


Ohhhh......this is good.



Wait for it...



It caused me to snort out my tea because I was laughing so hard....



Guess.



"Lower your seed for the tournament!"

Shaking things up

So one of my circle of friends is well connected within this town. And being a small town, it's who you know. She's a liberal as well, although I cloak better than she does. ;)

So awhile back, we were talking about the clinic and how I'm delivering these 13 and 14 year olds. Because of the overwhelming conservatism in this area, sex ed here is abstinence only and starts in the HIGH SCHOOL. I pointed out that I'm delivering 6th and 7th graders, maybe something needs to change.

So my friend hooked me up with the curriculum coordinators from the various school systems around here. I was pleasantly surprised that they were at least willing to listen to me and my suggestions. They want data on why abstinence only should be stopped. But it's a start. They also were surprised to hear that basic sex ed should be in elementary school...

My daughter is in 4th grade right now. I look at her and her classmates and know that I'll be seeing some of them within a few years. So, yeah, I'm a bit passionate about this.

And, yes, I practice what I preach and my children are aware of the basics. Correct names are used for anatomy.

Happy Birthday, Kiddo

6 years ago, we were blessed with a little boy. You are deeply loved. I didn't realize then just how lucky I was to get to be a mother to a boy, but now I am so happy you made your way into our lives. Your cake is in the oven as I type.

Happy birthday, Little Mr. Farty-Pants Stinky-Butt.

I live amongst wusses

So we got 2 inches of white stuff last night and school is canceled!!!!

I swear, people here don't know how to drive! And they're wusses!

But no, not me, I've got a full day of OR ahead of me...assuming patients show up.

Another milestone

My baby lost his first tooth. It's on the bottom, so it's not very visible, but still...


My baby's growing up. :(

Sick and Wrong

There is nothing better than an abscess that has the pressure built up so much that it spurts a foot as soon as it is incised. I think they are my favorite office visits.

Love them.

Biggest vulvar abscess I've seen was about the size of a football. Worst place for one (that I've seen) : right on the clitoris. OUCH!